This invention relates generally to internal surgery and, more specifically, to a reusable surgical device and methods for accessing and retrieving tissue or other mass from a body cavity.
In recent years, the applications for laparoscopic surgery have expanded to include many different procedures. A benefit of laparoscopic operations is the relatively quick recovery period experienced by patients, due to the small incisions that are made in the body. These incisions reduce the trauma and the required healing compared to traditional surgery. Laparoscopic tubes and sleeves with diameters on the order of 10 millimeters are inserted in the body cavity. Various instruments and a video camera are typically directed through laparoscopic sleeves for performing and monitoring the surgical steps.
A particular concern in laparoscopic surgery is the transporting of tissues and other masses that are cut away or retrieved during a surgery. While moving, manipulating, or cutting up a removed mass within the body cavity, pieces of infected or cancerous mass, blood, bile, and other liquids may escape into the body cavity and pose infection problems or other complications. It is desirable to contain these materials in a bag or similar enclosure within the body cavity before removal to minimize the risk of infection or other complications. It is important that the containment of the materials be accomplished as quickly as possible with minimal disturbance to the surgical site.
Instruments with membranes or bags have been designed in an attempt to avoid the complications associated with the removal of tissue during laparoscopic surgery. These devices typically fall into two categories, those that have a bag coiled around an introducing rod that must be unfurled by various maneuvers, and those that pop open a bag using a spring, wire, or other mechanism. A device that falls into the second category is a pouch disclosed in Pagedas (U.S. Pat. No. 5,368,597), which utilizes a flexible rod slidably connected to a wand to create a reclosable pouch. When the rod bows out, the bag is opened. When the rod straightens, the bag is closed to form a seal.
However, the specimen retrieval instruments that are currently on the market, especially the more practical devices, are designed for a single use. Not only does this create a disposal problem, but disposable instruments are not always cost effective. In this era of cost containment, the need often arises for reusable instruments, especially a laparoscopic retrieval pouch that can be sterilized and reused. A second failing of the current specimen retrieval instruments is that they are limited as to the specimen size that can be safely retrieved. A reusable instrument that can employ different size bags and allow rapid removal and replacement of a retrieval pouch would increase surgical efficiency. A third shortcoming of disposable specimen retrieval instruments is that specimen bags are often ruptured by morcelating instruments or pressure distention against the base of the retrieval bag. A reusable device warrants the additional cost of heavier gauge materials that can withstand the burden of a larger mass, the rigors of morcelation, and the stress of sterilization.
U.S. Pat. No. 5,368,597 (Pagedas) is incorporated herein by reference. Although Pagedas (U.S. Pat. No. 5,368,597) alludes to an option where one may slip a sleeve styled bag onto its device, no specific embodiment is given. Moreover, no mention is made of a reusable bag that may be sterilized.
For the foregoing reasons, there is a need for a reusable surgical device, and a method of using such a device, that allows efficient access and retrieval of tissue or other mass from a body cavity.
According to the present invention, the foregoing and following objects and advantages are achieved by providing a reusable surgical device for safely manipulating and retrieving tissue from a body cavity in operations such as laparascopic surgery, and also a method for using the surgical device. A surgical device having features of the present invention comprises an elongated wand having a front end and a back end, a rod having a flexible portion and a handle portion, and a removable bag. The flexible portion includes a second end attached to the handle portion, and a pivot end near the front end of the wand by a disengaging connector. The handle portion of the rod and the back end of the wand are close to each other so that they can be manipulated from outside a body cavity. Preferably the bag for enclosing and retrieving material during surgery is coupled to the front of the wand and the flexible portion of the rod. The bag may be opened by pushing the rod forward relative to the wand to bow out the flexible portion and may be closed by pulling the rod backward relative to the wand to straighten the flexible portion.
Another object is to provide a surgical device that may be accurately manipulated and controlled with one hand.
Another object is to provide a surgical device that has an adjustable opening that seals when closed.
Another object of the invention is to provide a surgical device that may be sterilized and reused. The reusable portions that can be sterilized may include the wand, the rod, and/or the bag.
Another object of the invention is to provide a surgical device that includes a lock that may be engaged so that a surgeon does not have to hold the device at the desired bag position. Bag positions may include a degree of openness ranging from completely closed to wide open, depending on the extent to which the flexible portion of the rod is bowed.
Another object of the invention is to provide a surgical device that includes a thumb grip to facilitate moving the rod.
Another object of the invention is to provide a surgical device with a pre-loaded cartridge for containing a rolled bag and having means for releasable engagement with an adjustable handpiece.
Methods of using the surgical device comprise the steps of attaching a bag to the front end of the wand and flexible portion of the rod, engaging the disengaging connector, directing the device into a body cavity, opening the bag by pushing the rod forward to cause the flexible portion to bow out, receiving a mass from the body cavity into the bag, and closing the bag by pulling the rod backwards to cause the flexible portion to straighten and form a seal against the wand. Additional steps may include morcelating the removed mass, removing the surgical device from the body cavity, disengaging the disengaging connector, removing the bag, disposing of the removed mass, and sterilizing the wand, rod and/or bag for reuse.
Accordingly, the present invention provides an economical means for achieving greater efficiency, control and safety in containing materials within, and removing materials from, a body cavity during laparoscopic surgery.
These and other features, aspects and advantages of the present invention will become better understood with regard to the following description. Other objects, advantages and novel features of the invention will become apparent to those skilled in the art. As will be realized, the invention is capable of other and different embodiments and use in other applications, and its several details are capable of modification in various obvious respects, all without departing from the invention. Accordingly, the drawings and descriptions are to be regarded as illustrative in nature and not restrictive.